Provider Demographics
NPI:1912506122
Name:FIRST RESPONSE TRANSPORT, LLC
Entity Type:Organization
Organization Name:FIRST RESPONSE TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIANNA
Authorized Official - Middle Name:CHANERIYA
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-718-3786
Mailing Address - Street 1:PO BOX 1013
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34220-1013
Mailing Address - Country:US
Mailing Address - Phone:941-713-1445
Mailing Address - Fax:
Practice Address - Street 1:3015 9TH AVENUE DR E
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-2403
Practice Address - Country:US
Practice Address - Phone:941-713-1445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)